Bacterial Vaginosis

Bacterial Vaginosis: Free advice – ask me today!

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By Dr Helen Webberley MBChB MRCGP MFSRH | GMC no. 3657058

I am a GP and a sexual health and hormone specialist. I can give advice on any medical matter, and I offer safe access to medical advice, prescription medication, blood tests and x-rays, and specialist referrals to your local private hospital as needed.

Bacterial Vaginosis (BV) – An Imbalance of Bacterial Flora

Bacterial Vaginosis isn’t really considered to be a sexually transmitted disease and it also shouldn’t be confused with the yeast infection, candidiasis.
A woman who has never had sexual intercourse can suffer with bacterial vaginosis and it can frequently recur. It is caused by an imbalance of naturally occurring bacteria in a woman’s vagina.
Often BV can come and go for no apparent reason, or following intercourse or a course of antibiotics.
The usual symptoms include a thin vaginal discharge which can have a very unpleasant, fishy odour. Burning and itching as may also occur.
If symptoms are new then it is important to have a test for sexually transmitted diseases to exclude other causes.

Frequently Asked Questions

What causes Bacterial Vaginosis?

It appears to be caused by an imbalance of bacteria (or flora) which occur naturally in the vagina. About 95% of vaginal flora are lactobacillus bacteria. These are ‘good’ bacteria which help to keep the vaginal pH slightly acidic, which is beneficial for maintaining a healthy vagina. Women with bacterial vaginosis have fewer lactobacillus organisms and an overgrowth of ‘bad’ bacteria which increases the vaginal pH. This produces symptoms of an unpleasant fishy discharge and itching.

A number of health and lifestyle factors have been linked to BV including;

douching

changes in sanitary products

not using condoms

tampons and having more than one sex partner

antibiotics

How is Bacterial Vaginosis Diagnosed?

BV can often be diagnosed by the typical symptoms. In those women with recurrent BV and no new sexual partners, then tests are often unnecessary.

If the symptoms are new then it is important to establish a diagnosis of BV and to exclude other sexually transmitted infections.

This can be done either through your GP, a “Special’ clinic or through STI testing kits purchased from your pharmacy or on line.

If your symptoms are persistent or severe it is very important to have a physical examination of your pelvis and vagina.

Do I need to see a Doctor?

In the vast majority of women, BV is a nuisance and no more. However if you have new symptoms or if they are persistent or severe, or if there is any abnormal bleeding, it is very important to have these checked out by a doctor.

It is important to exclude other sexually transmitted infections that may require specialist treatment, or any pelvic or vaginal pathology.

This may require a proper physical examination including an ‘internal’ or even ultrasound scans.

How is BV treated?

There are 2 main approaches to treatment. Oral antibiotics or intravaginal products.

The usual oral antibiotic prescribed is metronidazole (or Flagyl). This is usually prescribed for a week and although your symptoms may disappear very quickly, the course should be finished.

The other approach is the use of intravaginal products. These may may be either antibiotics or chemicals that improve the optimum vaginal pH, to allow the ‘good’ bacteria to flourish.

Sexual intercourse should be abstained from during the course of treatment to give it a better chance of working.

Medication

Metronidazole Tablets

Metronidazole is an oral antibiotic that works by entering the ‘bad’ bacterial cell and destroying it. As the ‘good’ lactobacilli are unharmed by this product, they then flourish and take over.
Metronidazole can cause nasty symptoms of nausea and vomiting if taken with alcohol and it also shouldn’t be taken in the first 3 months of pregnancy.

Metronidazole Vaginal Gel (Zidoval)

Metronidazole is also available as a vaginal gel and the commonest one used is Zidoval
Before using metronidazole vaginal gel, check with your doctor. Although there is no evidence of any harm to foetuses or newborn babies, it should probably be used with caution during pregnancy and if breastfeeding.

Lactic acid vaginal gels

There are several proprietary formulations available on the market. These principally contain glycogen which the lactobacilli feed off and produce lactic acid to improve the intervaginal pH.

Safe, real prescriptions for Bacterial Vaginosis.

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Tests

Vaginal Swab

A vaginal swab test involves using a small spatula and taking a sample of vaginal secretions to investigate possible sexually transmitted diseases. The kit can be sent to you in the privacy of your own home and is simple to perform.
The swab, is placed in a special container with its own envelope and is sent to the microbiology laboratory for further analysis. The result will then be discretely reported back to you with recommendations for treatment.

Full STI Check

It is important to exclude other STIs before starting treatment for your BV.
The test is performed on your urine and can be done in the privacy of your own home. The test is sent away to a laboratory for analysis and the result plus treatment recommendations, are discretely reported back to you.
The testing kit is accurate and reliable and tests for chlamydia, gonorrhoea, mycoplasma, ureaplasma, trichomonas vaginalis, gardnerella vaginalis and herpes simplex types I/II.